Huri Emre, Akgül Turgay, Ayyildiz Ali, Ustün Hüseyin, Germiyanoğlu Cankon
Second Urology Clinic, Ankara Training and Research Hospital, Ankara, Turkey.
J Urol. 2009 May;181(5):2349-54. doi: 10.1016/j.juro.2009.01.016. Epub 2009 Mar 19.
Ankaferd BloodStopper is a mixture of 5 plants used in traditional Turkish medicine as hemostatic agent for external traumatic, postoperative and dental bleeding. We investigated the hemostatic efficacy of Ankaferd BloodStopper for partial nephrectomy.
A total of 24 Wistar rats were divided into 4 groups of 6 each. Group 1 underwent partial nephrectomy with hilar control as the conventional technique. Group 2 underwent the conventional technique with hemostatic agent application. Group 3 underwent hemostatic agent application to the renal parenchyma. In Group 4 partial nephrectomy was performed and the hemostatic agent was used without hilar control. Warm ischemia and partial nephrectomy times, and the number of hemostatic agent applications were recorded. Histopathological evaluations were completed. The Fisher, Kruskal-Wallis and Mann-Whitney U tests were used for statistical analysis.
Mean kidney size was 2 x 2.5 x 0.05 cm. Mean partial nephrectomy time was 3.7, 2.7, 1.8 and 3.2 minutes in groups 1 to 4, respectively, which was significantly different between groups 1 and 3 (p = 0.007). Warm ischemia time in group 3 was less than in group 1 (p = 0.011). The number of hemostatic agent applications was higher in groups 3 and 4 compared to those in group 2 (p = 0.003). Glomerular necrosis was detected at a higher rate in group 1 compared to that in groups 3 and 4 (p = 0.015). Calcification formed significantly more in group 1 than in groups 2 to 4 (p <0.05). Erythrocyte aggregation was greater in groups 2 to 4 than in group 1 (p = 0.015). Giant cell reaction, fibrosis, inflammation and microvascular proliferation were not statistically different among the groups (p >0.05).
Ankaferd BloodStopper decreases partial nephrectomy and warm ischemia times, and provides hemostasis. Erythrocyte aggregation confirmed the hemostatic action of the agent, while the absence of glomerular necrosis and calcification may have positive relevance.
安卡菲德止血剂是一种由5种植物混合而成的药剂，在传统土耳其医学中用作外部创伤、术后及牙科出血的止血剂。我们研究了安卡菲德止血剂在部分肾切除术中的止血效果。
将24只Wistar大鼠分为4组，每组6只。第1组采用肾门控制的部分肾切除术作为传统技术。第2组采用传统技术并应用止血剂。第3组将止血剂应用于肾实质。第4组进行部分肾切除术且使用止血剂但无肾门控制。记录热缺血时间、部分肾切除时间以及止血剂的应用次数。完成组织病理学评估。采用Fisher检验、Kruskal-Wallis检验和Mann-Whitney U检验进行统计分析。
平均肾脏大小为2×2.5×0.05 cm。第1至4组的平均部分肾切除时间分别为3.7、2.7、1.8和3.2分钟，第1组和第3组之间差异有统计学意义（p = 0.007）。第3组的热缺血时间短于第1组（p = 0.011）。与第2组相比，第3组和第4组的止血剂应用次数更多（p = 0.003）。与第3组和第4组相比，第1组肾小球坏死的发生率更高（p = 0.015）。第1组钙化形成明显多于第2至4组（p <0.05）。第2至4组的红细胞聚集程度高于第1组（p = 0.015）。各组间巨细胞反应、纤维化、炎症和微血管增生无统计学差异（p >0.05）。
安卡菲德止血剂可缩短部分肾切除时间和热缺血时间，并实现止血。红细胞聚集证实了该药剂的止血作用，而未出现肾小球坏死和钙化可能具有积极意义。
